Battle sign trauma full#

Glasgow coma scale (GCS) of 12 or less on initial assessment in the emergency department.

People 16 and over: do a CT head scan within 1 hour of any of these risk factors being identified:

Continuing concern about the diagnosis.

Irritability or altered behaviour (easily distracted, not themselves, no concentration, no interest in things around them), particularly in babies and children under 5.

Any safeguarding concerns (eg, possible non-accidental injury or a vulnerable person is affected).

Current anticoagulant and antiplatelet (except aspirin monotherapy) treatment.

Any history of bleeding or clotting disorders.

Any vomiting episodes since the injury.

Amnesia for events before or after the injury.

Any loss of consciousness because of the injury, from which the person has now recovered.

Indications for referral to hospital A&E department

No other way of safely transporting the person to the hospital emergency department.

Any suspicion of a complex skull fracture or penetrating head injury.

Any focal neurological deficit since the injury.

Battle sign trauma full#

Unconsciousness or lack of full consciousness (eg, problems keeping eyes open).Indications for referral to emergency ambulance services (999) for emergency transport to A&E See also the articles on Trauma Assessment and Spinal Cord Injury. Pre-hospital treatment Resuscitationīasic and Advanced Trauma Life Support, and Basic and Advanced Paediatric Life Support as necessary.

See also the articles on Spinal Cord Injury and Whiplash and Cervical Spine Injury. They present with delayed onset of neck pain.There is no midline cervical spine tenderness.They have been ambulatory at any time since injury.They are comfortable in a sitting position.They were in a simple rear-end motor vehicle collision.

Only do the assessment if they have at least 1 of these low-risk features: The range of movement in the neck when there is clinical suspicion of a cervical spine injury can only be assessed safely before imaging in people with a head injury if they have no high-risk factors (list of risk factors under indications for CT cervical spine below).

The priority is to get the patient to hospital and CT scanned within the first hour after injury.

Resuscitate but make a quick assessment of GCS and pupils.

Look for other possible injuries and any other relevant examination.

Neurological assessment - full history and examination make notes of pupil size and reaction to light.

Haemodynamic status - pulse rate, blood pressure, fluid status.

Following this: In patients with normal or near-normal Glasgow coma scale (GCS) score and who are alert Management should begin immediately with resuscitation. Head injury patients should be taken directly to a centre which can provide resuscitation and management of head injuries and trauma leading to multiple injuries.

Alcohol may be involved in up to 65% of adult head injuries.

Road traffic accidents account for a far greater proportion of moderate-to-severe head injuries.

Falls (22-43%) and assaults (30-50%) are the most common cause of a minor head injury, followed by road traffic accidents (25%).

One UK survey of children aged less than 15 years who were admitted to hospital found that the peak prevalence of hospital admission for head injury was in infants (19.2% of admissions).

About 90% of people attending emergency departments with a head injury have a minor head injury.

Approximately 200,000 people are admitted to hospital each year following head injury. 33–50% of these are children aged under 15 years.

Approximately 1.4 million people attend emergency departments in England and Wales each year with a recent head injury.

The incidence of head injury is difficult to assess as it varies according to the study definitions used and the point in the care pathway where people with head injury are assessed.

How common is head injury? (Epidemiology)

Secondary (injury as a result of neurophysiological and anatomical changes minutes to days following primary insult - eg, from cerebral oedema, haematoma or increased intracranial pressure).

Primary (damage occurring at the time of impact).

Traumatic brain injury may also be categorised as: Traumatic brain injury can be categorised as mild (concussion), moderate, or severe. Traumatic brain injury occurs when head injury results in a disturbance of normal brain function.